Drop-out, relapse and abstinence in a cohort of alcoholic people under detoxification

Abstract

The Obsessive Compulsive Drinking Scale (OCDS) was developed to reflect obsessionality and compulsivity related to craving and drinking behaviour for revealing in the long-term drop-out, abstinence and relapse. This study evaluates the early OCDS predictive value in drop-out, abstinence and relapse of patients suffering from Alcohol Use Disorders (AUD) for discovering an OCDS total score cut-off capable of disclosing patients most at-risk of relapse during the beginning of the therapeutic intervention in the Day-Hospital period. The sample includes 263 AUD patients, with 192 men and 71 women. The OCDS scores were measured during the two-weeks Day Hospital treatment for detoxification and after 30, 60, 90 and 180 days after discharge. We also investigated the association between the all OCDS scores and abstinence and between craving, relapse and drop-out. We found that high values of OCDS during Day Hospital detoxification may predict a lower ability to maintain abstinence with elevated relapsing probabilities. Surprisingly, early dropping-out AUD people had lower OCDS total scores. However, significant differences in OCDS values in dropping-out AUD people were revealed mainly 90 and 180 days after discharge compared to no dropping-out AUD subjects. Craving measured also after 30, 60, 90 and 180 days from discharge in AUD relapsers, with OCDS values comprised between 6 and 10, could indicate a lower ability to continue abstinence. In conclusion, OCDS may be a useful tool to early discriminate AUD people at-risk for relapse and drop-out and for addressing the specialist to adjust both medical treatment and psychological support during crucial moments of patients' treatment and follow-up.

Keywords: Alcohol use disorders; Craving; Drop-out; Relapse; Withdrawal.